NPI | 1396003844 |
---|---|
Entity Type | Organization |
Authorized Contact | JAYMIE D CORIA Dentist 909-936-6213 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52595) |
Enumeration Date | 2012-05-02 |
Last Update Date | 2013-10-04 |